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[Update (August 2016): Since writing this post in 2011 about an odyssey that began in 2009, our hypothesis that Amy has fructose malabsorption has been disconfirmed. I hope the information in this post will still be of use to those who have similar hypotheses, or confirmed diagnoses. Amy still suffers from periodic episodes of extremely painful abdominal cramping and some of the other symptoms described in the original post, but our current hypothesis is that these are psychosomatic, the result of life-long challenges in processing emotions such as fear and anxiety (similar in some respects to the patterns described by Scott Strossel in My Age of Anxiety). Others experiencing an epic digestive health odyssey might benefit from considering potential psychological or emotional factors - in addition to the physiological factors - that may be contributing to the suffering. We hope the information here will be instrumental in ameliorating, or at least explaining, some of that suffering, or at least offer some consolation that you are not alone in the intense pain, desolation and desperation that often arises on such a journey.]

After over two years of intermittently intense suffering, an interminable series of medical consultations with a variety of healthcare professionals, and numerous indefinite diagnoses, a dietician recently helped us converge on a new explanation for my wife's digestive health problems: fructose malabsorption (FM). Having experienced some relief from recently starting an elimination diet, it appears that Amy's small intestine does not properly absorb fructose and its many polymerized forms such as fructans, raffinose and other Fermentable Oligo-, Di- and Mono-saccharides And Polyols (FODMAPs). These are the sugars contained in many fruits, vegetables and whole grains. As we currently understand her predicament, when she consumes foods or drinks - or even chews gum - containing moderate amounts of fructose, a fructose-glucose ratio greater than 1:1, or any amount of other FODMAPs, they are not absorbed in her small intestine but pass through to her large intestine. The unabsorbed sugars feed bacteria, and the resulting fermentation leads to a range of symptoms that have included varying degrees of abdominal pain (3 extreme episodes involved pain "worse than childbirth", vomiting and trips to the emergency room), bloating, belching, diarrhea, decreased appetite and visceral hypersensitivity. During this time, she has also experienced skin rashes, muscle and joint pain, dry eyes, dry mouth, fuzzy head, fatigue and depression, but at this point we're not sure whether or how these symptoms may be related to fructose malabsorption.

Candidates that have not yet been definitively ruled out include ileus, bowel obstruction and small intestinal bacterial overgrowth (SIBO) syndrome (in which the unabsorbed sugars are fermented in the small intestine rather than the large intestine). Mast cell activation syndrome (MCAS), a relatively unknown and ill-defined disorder in which mast cells precipitate an allergic overreaction (which in some people may include anaphylactic shock), is the most recent addition to the candidate list. Irritable Bowel Syndrome (IBS) is a much better known but not not much better understood disorder which has a high degree of symptom overlap with fructose malabsorption (and SIBO); we're note quite sure what to make of IBS, but Amy's IBS-related symptoms have significantly improved through the dietary management of fructose. Some of these conditions are suspected of being interrelated, and it may be the case that several of these diagnoses apply.

During a visit to Amy's gastroenterologist last Friday, he suggested that MCAS may be the genesis her FM/IBS symptoms - possibly triggered in response to an earlier gastrointestinal infection - and so she is preparing to add antihistamine and quercetin to her daily regimen to reduce the likelihood of future [over]activation. He also suggested that the rapid intestinal transit that was observed in an X-ray of her upper GI with small bowel follow-through may be a factor - fructose may not be absorbed in her small intestine because it simply isn't given enough time - and so he also recommended a daily dose of Imodium (Loperamide) to slow down the intestinal transit. I hope to have more to say about this trajectory in a future post.

Exploratory abdominal surgery was recommended by a few different specialists at earlier stages of her digestive health odyssey; thus far, concern over possible complications resulting from gastrointestinal surgery - which can introduce as well as reduce digestive problems - has steered her away from that path. However she did undergo hyperbaric oxygen (HBO) treatment at the Center for Wound Healing and Hyperbarics at Swedish Edmonds this spring to treat radiation enteritis, when that seemed to be the most likely diagnosis. HBO is a relatively unknown and minimally invasive treatment that appears to be effective for several conditions, and we were initially hopeful about prospects for improvement. Although she received excellent care over the course of her treatment, the lack of significant improvement in her digestive symptoms after 37 "dives" was a strong signal that radiation enteritis was not the correct diagnosis. She also underwent a course of Xifaxan (Rifaximin) antibiotic treatment for SIBO at the start of her HBO treatment, but the persistence of symptoms during that period lead us to believe that SIBO is/was not a primary factor.

Fructose malabsorption seems to be relatively unknown, at least in the U.S., and there are many aspects of the disorder that are still poorly understood. A review of studies on fructose malabsorption, most of which are based on results of hydrogen breath tests (HBTs), suggests that some level of fructose malabsorption may be present in more than a third of the "healthy" population in western countries, where high fructose corn syrup is increasingly used in popular consumer foods. HBT evidence of fructose malabsorption is present in a much larger proportion of those exhibiting symptoms associated with functional gastrointestinal disorders (FGIDs). However, there is some disagreement about the application and interpretation of HBTs, as well as the correlation between HBT results and FGID symptoms; there is also the risk of triggering severe reactions on the way to a "positive" test result, as some fructose must be ingested prior to measuring the hydrogen in the breath. In Amy's case, she has not taken an HBT, but we consider her body's positive response to a diet restricting fructose and other FODMAPS - and the negative response whenever she unintentionally eats even small amounts of high-FODMAP foods - to be strong evidence that fructose malabsorption is at or near the core of many of her digestive health problems.

Given the different tests, diagnoses and treatments Amy has undergone during this odyssey, one of the motivations behind composing this post is to share some of this experience in case it might help others who are unknowingly suffering from fructose malabsorption yet have only been tested, diagnosed or treated for other diseases or disorders. Amy is an indomitable e-patient - engaged, empowered, equipped and increasingly expert in her own medical care - and I'm hoping her journey may help inform or inspire others. If not for her perseverance, she may have undergone other, potentially more invasive or risky treatments, and might still be suffering [more] from the often debilitating symptoms.

That is not to say she is not still suffering; the source of suffering has simply shifted from severe reactions to food to severe restrictions on food. There is no known cure for fructose malabsorption, and it appears the most effective treatment is an austere low-FODMAP diet, devoid of most fruits, vegetables, grains and other sources of sugars that can feed the bad bacteria. Based on some recent negative food reactions, we suspect that Amy may also be lactose intolerant - lactose being another sugar - and so she is also currently avoiding all dairy products. Years ago, she discovered that foods high in saturated fat triggered negative reactions - her digestive health odyssey actually began decades ago - so those foods were already eliminated from her diet.

At this point, nearly all the things she most enjoys eating and drinking - including many fresh fruits and vegetables, whole grains, cheeses, chocolate, wine and beer - are now on the "avoid" list. Many activities and places that used to bring her joy - such as growing fruit and vegetables in her garden, exploring farmers' markets, trying new restaurants - are now also on an "avoid" list, serving as depressing reminders of the life she enjoyed until recently. As one among many examples, the strawberries in her garden [shown in the photo at the right] recently achieved optimal ripeness and were ready for harvest, and although they are a generally "safe" food in the low-FODMAP diet, she had a negative reaction to eating a store-bought strawberry a few weeks ago, and so she could only pick but not eat them. One of the many puzzling dimensions of this disorder is why she can no longer tolerate so many nutritious foods she used to eat regularly; it's as though some kind of switch has been flipped. While we have found no evidence that fructose malabsorption is a life-threatening disorder, it is certainly proving to be a lifestyle-threatening disorder, and the psychological adjustments are at least as challenging as the physical ones.

The good news is that after six weeks on the diet, many of her physical symptoms have been greatly alleviated; the bad news is that many of the generally "safe" foods she has tried to re-introduce so far have re-triggered negative physical - and emotional - reactions.

Margaret Mead famously observed that

Always remember that you are absolutely unique. Just like everyone else.

This individual and collective uniqueness is a significant factor for those suffering from fructose malabsorption ("FMers") and following a low-FODMAP diet, in that foods that are safe for one FMer - or even most FMers - may not be safe for another FMer (e.g., strawberries). Further complicating matters, heating (cooking) and cooling (refrigeration) affects the chemistry of foods, as does ripeness (in the case of fruits and vegetables), and so foods that may be safe in one state may not be safe in another. Foods that might be safe in isolation may not be safe when consumed soon before or after other foods that also might be safe in isolation. The set of safe foods for a given FMer can also change over time. We keep hoping it will get better, that her gut will heal and she will eventually succeed in reintroducing some of the eliminated foods. It appears that "getting better" involves some combination of radically adjusting the diet and the associated gustatory expectations and desires, as well as managing stress through exercise and mindfulness meditation ... and practicing a great deal of patience.

Amy is currently at the most restrictive phase of the low-FODMAP diet. She has eliminated everything but fish, chicken, lean beef and pork, oatmeal, white rice, rice pasta, rice crackers, quinoa, buckwheat, banana, grapefruit, portabella mushrooms, mustard greens, Swiss chard, spinach, almond milk, an assortment of seeds, oils and nut-based butters, and decaffeinated coffee. The photo on the right shows the single shelf containing all of the non-perishable foods she can safely eat at this stage [since taking the photo, we discovered that the shallots in the bowl at the right are not low-FODMAP and have been eliminated]. We hope this is a temporary low, and she will eventually reach a stage where we will need more than one shelf to store her food.

After achieving a state of greater digestive balance in the first two weeks, Amy started experimenting with reintroducing other generally "safe" foods (e.g., blueberries), several of which have resulted in a mostly mild recurrence of symptoms. Just this week, she had an extreme bout of abdominal pain - almost on a par with the bouts that brought us to the emergency room - that, as far as we can determine, resulted from eating a few sea salt & cracked pepper flavored potato chips. We later discovered that one of the other seasonings listed in the ingredients included onion powder, which is on the low-FODMAP "avoid" list, reminding us of how diligent and vigilant we need to be about checking ingredients.

Due to the cumulative effects of unabsorbed sugars in the gut, low-FODMAPpers are advised to wait 72 hours between experiments, so as to be able to correctly assess the credit (or blame) for any symptom recurrence. Another recent failed experiment occurred after eating 1/2 of a leftover baked potato (with a small amount of "safe" margarine and no skin) a few weeks ago. The next day, shortly after eating her standard breakfast of plain oatmeal, she experienced the waves of sharp abdominal pain that characterized her worst reactions. We have since learned that starch can be problematic, at least in the early phase of the diet, and that refrigerating potatoes increases their starch content. We also discovered that oatmeal contains starch, so the abdominal pain may have been triggered by an inadvertent starch overload. We hope to redo the experiment with freshly cooked potatoes, which are a generally "safe" food, during an otherwise low-starch period, in the hope that they will prove safe for her to eat again.

Amy sometimes fears that she will never be able to reintroduce eliminated (or new) foods, regain weight or acquire the nutrients - through food - that her body needs. She has been compensating for nutritional deficits through supplements including UltraClear Medical Food and calcium citrate, and has also been experimenting with the probiotic VSL#3; many supplements contain FODMAP ingredients, so she needs to be careful with those as well. Over the past 2 years, she has lost 20 pounds (9 kg) and now weighs 110 pounds (50 kg); she stands 5'8" (173 cm) tall, yielding a body mass index of 16.7, well below the "underweight" threshold of 18.5. This is particularly worrisome because none of the foods that have proved safe for her to eat [yet] are foods that can help her gain weight. Even at the worst / lowest point during her recovery from radiation and chemotherapy treatment, she weighed 117 pounds (53 kg). The lack of absorbed nutrients is likely contributing to osteopenia bordering on osteoporosis. On top of all this, her hair has also been thinning [again] throughout this time. The photo at the right was taken a little over a year ago, on the 5-year anniversary of her successful cancer treatment; little did we know then that this would represent a relatively brief crest amid the sporadically crushing waves of health challenges.

When Amy was diagnosed with anal cancer in 2005, the early stage of the diagnosis gave us confidence that there was a high probability the treatment would be successful (it was), and the side effects would eventually subside (they have). When she was diagnosed with multiple sclerosis in 1986, the long gaps between her initial exacerbations gave us hope that she would not suffer the steady and progressive deterioration that some with MS experience (she has not). The fructose malabsorption diagnosis - and low-FODMAP dietary treatment - have left her feeling more isolated and depressed than any prior health challenge. It often seems like no one - at times, including me - fully grasps the magnitude of the restrictions she may be facing, possibly for the rest of her life.

As I noted above, one reason I am writing this post is to share her (our) experience of this odyssey, in the hope that it might help others become more aware of a condition that may be widely experienced (to varying degrees) and not [yet] widely diagnosed or appropriately treated, especially in the U.S. Our hope is that we might save other sufferers some of the pain, time and money - not to mention fear, uncertainty and doubt - that we have experienced over the past several years. I plan to share more of the ongoing odyssey in future posts, similar to the "cancer counterinsurgency" series I posted during Amy's anal cancer diagnosis, treatment and recovery (which has generated more comments and email than anything I've written). We've discussed the prospect of Amy starting her own blog to catalog her journey, but for now, she is focused more on learning than sharing, as she adopts and adapts new ways to nourish and nurture herself through nutrition, exercise and stress reduction.

I'll finish off this post with a few resources that I / we have found particularly helpful:

Heidi Turner, RD, is the Medical Nutritional Therapist at Seattle Arthritis Clinic, which we first visited when Sjogren's Syndrome was a candidate diagnosis (subsequently ruled out via lip biopsy). Heidi helped us converge on the fructose malabsorption diagnosis, and she has continued working with Amy through office visits, telephone consultations and email to help her navigate to a safe, if severely restricted, baseline diet and gradually experiment with reintroducing eliminated foods. Her web site offers a number of resources to support the elimination diet (which can be applied or adjusted to support other digestive disorders).

Sue Shepherd also has a dietician practice in Australia, Shepherd Works, and has posted many resources regarding fructose malabsorption, FODMAP intolerance and other digestive disorders such as celiac disease, irritable bowel syndrome and lactose intolerance. These resources include research articles and books such as the The Low FODMAP Diet and The Food Intolerance Management Plan [unfortunately, the shipping charges from Australia may make these prohibitively expensive for some prospective American readers].

Gabor Mate's 2003 book, When The Body Says No: Understanding the Stress-Disease Connection, makes a compelling case for the the role stress plays in the onset and progression of many chronic conditions such as IBS, cancer, multiple sclerosis, arthritis, diabetes and heart diseases. The author, a practicing physician, also emphasizes the importance for doctors and other medical professionals to pay attention to patients' life stories - not just their symptoms - in their efforts to promote effective healing.

I want to emphasize that neither Amy nor I have any formal training in medicine, nutrition or biochemistry; the information shared here is based on the personal experience of a long-time sufferer and her spouse. Based on our interactions with various health care professionals over the last several years and my own reading of over 40 peer-reviewed articles in medical research journals over the last several weeks, we appear to be at the beginning stages of a very steep learning curve involving a condition - or perhaps several - that do not seem very well studied or understood. I also want to highlight the fact that we are still not sure whether fructose malabsorption is the primary diagnosis or is secondary to other conditions (such as MCAS, IBS and/or SIBO). This is why the subtitle of this post is the latest milestone - vs. diagnosis - on a digestive health odyssey ... and our epic journey continues.

While we expect - or hope - that most people will never experience the symptoms of fructose malabsorption, or the challenges of the restrictive diet used in its treatment, we also hope that those who are suffering from these symptoms - or know someone else who is - and thus may be candidates for the diagnosis and dietary treatment, might benefit from this summary of our experience thus far, and seek out personalized care and guidance from appropriately trained health care professionals.

Jonah Lehrer, the 27 year old author of How We Decide, gave the Opening Days convocation keynote at Willamete University last Friday. After being introduced by Willamette president M. Lee Pelton as "a humanist disguised as a neuroscientist", Lehrer offered a fun and fascinating whirlwind tour of neuroscience, psychology and sociology, in the context of a 5-point guide to how to succeed in (and through) college. Having attended several convocations both as a student and a faculty member, I would rank his keynote as one of the best I've ever heard, rivaled only by one I heard in 1986, by Theodor Seuss Geisel (aka Dr. Seuss), when he received an honorary doctorate at the University of Hartford (so he really was a "doctor").

Leading off with a story demonstrating the ephemeral nature of many "great truths" (Oliver Wendel Holmes, Sr., discovering the great "truth" that the world smells like turpentine - specifically, "a strong smell of turpentine prevails throughout" - while on a nitrous oxide-induced hallucinogenic journey), Lehrer assured the new students that they will regularly encounter profound truths and discover new ideas ... few of which will have impact lasting beyond 72 hours, and nearly all of which will be forgotten soon after they finish college. The real value of a college education is learning how to think ... and to promote this process, he offered 5 tips.

Be an outsider

Innocentive.com is a platform for crowdsourcing research and development that succeeds primarily through the participation of outsiders. Companies post problem descriptions and offer prizes for solutions, and individuals and organizations outside the company submit potential solutions. Lehrer quoted a Harvard Business School study reporting that 60% of the posted problems are solved within 6 months, and that the key to solutions is being on the outside, i.e., being able to look at the problem from an outsider's perspective.

InnoCentive now boasts 175,000 "solvers" from more than 200 countries around the world. About 90% are individuals, 10% are organizations and 60% have masters degrees or PhDs. Last year, nearly 50% of the "challenges" posted on InnoCentive's web site generated a solution that was put to use.

Academics who polled InnoCentive's winning solvers discovered something "both startling and intuitively obvious," said Spradlin. "What they found was that typically ... the background of the solver who solved the problem" was "no less than six disciplines away" from the subject area in which the problem emerged. "What that means is, if all the Stanford PhDs in your chemistry lab could have solved the problem, they would have solved it already."

Lehrer reported that English poet Samuel Taylor Coleridge used to tell people he attended public lectures on chemistry in London "to improve my stock of metaphors", and encouraged students to take at least one class each semester outside of their field ... and "don't be afraid to be the lonely poet in chem class".

Learn how to relax

Lehrer described a study on people solving compound remote associates problems, for which Lehrer suggested the evocative acronym "CRAP". Another acronym, "RAT" (remote associates test), is more commonly associated with these kinds of problems - often posed on the Sunday Puzzle on NPR - in which three words are presented and the problem is to find a fourth word that relates to all of them (e.g., given the problem "broken, clear, eye", the solution is "glass"). The study revealed that the "flash of insight" or "Aha!" moment that occurs immediately before a solution can be reliably detected via functional magnetic resonance imaging (fMRI) and electroencephalography (EEG), and the alpha wave pattern closely resembles that of someone who has experience in meditation, i.e., someone who is able to achieve states of deep relaxation.

Contrary to the intuition many of us have when faced with a hard problem, which is to focus on the problem as hard as we can (I imagine this is why they are called "hard problems"), the solution in many cases is to simply relax and temporarily turn our attention to other things, and allow the solution to emerge more organically. I was reminded of one of my favorite lines of poetry, by Wallace Stevens:

Perhaps the truth depends on a walk around a lake.

Another observation by Lehrer - the brain knows more than you know, you just have to listen - reminded me of the way yet another poet, David Whyte, describes poetry:

Poetry is the art of overhearing yourself say things you didn't know you knew.

But I digress. Shifting from poetry to technology - and back to Lehrer's speech - Lehrer suggested that one of the most effective ways of listening to what you know is to turn off the gadgets that constantly inundate us with what others are saying ... reminding me of what Sherry Turkle, Kathy Sierra, James Surowiecki, Malcolm Gladwell, James Ogilvy, Dan Oestreich and other great thinkers have said about self-reflection vs. self-expression, and the recent New York Times article on digital devices deprive brain of needed downtime.

Make friends with lots of different people

Lehrer described the self-similarity principle (or perhaps homophily) as a natural tendency to associate with people who are like us (and avoid people who are not like us), and suggested that students guard against this tendency. A study by sociologist Martin Ruef and his colleagues at Princeton, in which they interviewed 600 entrepreneurs, revealed that the entrepreneurs with the highest informational entropy (i.e., most diverse social networks) were the most successful, and that the propensity to strike up conversation with potentially consequential strangers was a key indicator of this quality. The researchers estimate that entrepreneurs with highly entropic networks were 3 times more innovative than those with low entropy networks (though innovation is a notoriously difficult concept to measure).

College is a great place to forge new connections with a broad range of people, and so Lehrer encouraged students to take advantage of the opportunity to diversify their social networks ... which will seve them well long after they've forgotten all (or most of) the facts they will have learned while in school.

Don't eat the marshmallow

Another variation on the theme of intent focus vs. relaxation - or, at least, distraction - was illuminated through the story of the marshmallow task, which Lehrer wrote about in a New Yorker article on the secret of self control last May. Stanford psychology professor Walter Mischel conducted experiments with four year olds at the Bing Nursery School, including one named Carolyn, to explore delayed gratification:

Carolyn was asked to sit down in the chair and pick a treat from a tray of marshmallows, cookies, and pretzel sticks. Carolyn chose the marshmallow. ... A researcher then made Carolyn an offer: she could either eat one marshmallow right away or, if she was willing to wait while he stepped out for a few minutes, she could have two marshmallows when he returned. He said that if she rang a bell on the desk while he was away he would come running back, and she could eat one marshmallow but would forfeit the second. Then he left the room [for about 15 minutes].

Only 30% of the children were able to delay gratification for the full 15 minutes; the average delay of gratification was about 2 minutes. 13 years later, Mischel conducted extensive followup surveys to discover how the 600+ children had fared. The high delayers - those who were able to distract themselves for the full 15 minutes - averaged 200 points higher on the SAT, on average, than the low delayers - those who were unable to shift their attention to anything but the marshmallow, and succumbed to temptation within 30 seconds.

Lehrer instructed the students that "your task for the next four years is to learn how to control your attention. You control the spotlight" - use it wisely.

Inhale

Elaborating on a theme invoked by Dean Darlene Moore during the opening remarks to the event - in which she emphasized the primacy of the journey over the destination - Lehrer invited students to fully appreciate the experience of a college education. Highlighting the importance of embracing wrongology, Lehrer offered a great anecdote:

You get to share your opinion on Hamlet, and write long essays about how Plato, the guy who blew your mind last week, was actually wrong about everything.

In my own experience as a philosophy major years ago (and continuing ever since), education is about learning things, and then unlearning things; discovering a great truth, and then discovering that its opposite is [also] true. I can understand the appeal of fundamentalism, in clinging tenaciously to beliefs no matter what facts may present themselves, especially as fears, uncertainties and doubts are promulgated by those who would deign to decide for us, but I don't think we can learn much when we are not willing to be in the question(s).

Speaking of questions, during the question & answer period following his talk, my favorite question was by a student who asked how Lehrer figures out which questions to ask (or pursue). He answered that he wrote a book about decisions primarily because he is pathologically indecisive, and generally tends to begin with his own frustrations ... mirroring my own tendency toward what I like to call irritation-based research ... or what Eric Raymond, author of The Cathedral and the Bazaar, describes in the context of open source programming:

Every good work of software starts by scratching a developer's personal itch.

In closing, I want to acknowledge that I have not yet read Lehrer's book, How We Decide, but as I noted in my earlier post on the warm welcome we enjoyed throughout Willamette Opening Days, my daughter, Meg, read the book over the summer, and after his speech she told me that many of the examples are covered more extensively in the book, which is next on my stack of "to-reads".

Finally, I want to loop back to some introductory remarks made by President Pelton, in which he quoted E. O. Wilson, the multidisciplinary scientist sociobiologist who contributed much to our understanding of ant colonies (and other societies and systems):

We are drowning in information, while starving for wisdom. The world henceforth will be run by synthesizers, people able to put together the right information at the right time, think critically about it, and make important choices wisely.

Lehrer, like Wilson, is clearly a great synthesizer, and I hope his convocation keynote - and the subsequent scope of a liberal arts education at Willamette - will help inspire a future generation of synthesizers, critical thinkers and wise decision-makers.

We brought our daughter down to Willamette University this week and enjoyed a warm welcome during their Opening Days orientation program. I had written about our short tour of small colleges in the Pacific Northwest last March, which included Willamette and several other schools she was considering. Meg eventually applied to and was admitted to several very good schools, some of which included attractive scholarship offers. The overall package of education quality, campus life and scholarship offered by Willamette seemed to offer the best fit for her aspirations, and our experience at opening days only reinforced the sense that she had made the right decision.

When we arrived at the Salem, OR, campus after our 4-hour drive Thursday morning, we were pleasantly surprised to be greeted by a group of Willamette Bearcats football players and students from Tokyo International University of America - which is affiliated and collocated with Willamette - who offered to carry Meg's stuff up to her dorm room. The football players have traditionally helped new students who are on the team move in; this year, Scott (second from left in photo to the left) said he thought it would be a nice gesture - very much in keeping with the traditions of community service at Willamette - to help all students move in this year. TIUA also has a strong tradition of community service. A collection of students from both groups came right up to the van, each grabbing an armful of stuff, and had all of Meg's things outside her room in under 5 minutes. This was the third time we've been to the campus, and each time we had a positive experience, but I have to say that this initial greeting made a powerfully positive impression on us.

After lunch at Goudy Commons, we attended the Welcome Program for New Students and Families, which included presentations by Willamette President M. Lee Pelton, VP of Enrollment & Financial Aid Madeleine Rhyneer and Opening Days Coordinator Emma Larkins. Among the things we learned was that this year was the first time that Willamette admitted fewer than 50% of its applicants; other statistics revealed on the welcome page for the class of 2014 include a median SAT score of 1870 (50 points higher than last year's class), a median high school GPA of 3.79, and over half (51%) ranked in the top 10% of their high school graduating class (a 10% increase from last year). We also learned that many of the Opening Days coordinators are pretty good dancers.

The students and their families were then separated, and Amy and I attended a session on Campus Life at Willamette. I had never heard of the Family Educational Rights and Privacy Act (FERPA) before - even though it was enacted in 1974, and so was in force when I attended college - but we learned that a student must sign a waiver for the university to release any information about any aspect of the student's life and work at the school. We also learned about a range of counseling and other support services available to students at the college.

Having been deeply disturbed by a recent NPR series on campus rape - an estimated 20% of women are sexually assaulted at some point during their college career, and even at the most progressive institutions (with respect to this issue) only 10-25% of men found guilty of sexual assault are expelled - I asked about the prevalence and policies regarding sexual assault on campus. Margaret Trout, Director of the Bishop Wellness Center on campus, said that the prevalance of non-stranger sexual assault at Willamette is consistent with the national average, and that a survivor can choose whether to press charges with the Salem police or through the Willamette judicial system; if they choose the campus judicial system, and the perpetrator is found guilty, that person will be expelled. She also said that the campus has trained student volunteers who serve as sexual assault response allies, and this has increased both the reporting and effective response to sexual assault on campus. On the one hand, I was reluctant to raise the issue in the session (or in this post), but on the other hand, I think it is very important that parents - and students - be aware of how prevalent this problem is, and how ineffective many schools are in dealing with it.

After the campus life session, parents and students enjoyed a nice picnic dinner while being entertained by the Los Palmeros Mariachi band. We discovered that a friend and former colleague from the Seattle area also has a son who is an entering freshman at Willamette, and that the son's best friend - whose older brother is a junior at Willamette - is also a freshman there. It was nice to reconnect with local friends and to discover that there is a tradition of siblings attending the same school (not that we have any preconceived notions that what is appealing to Meg will be appealing to Evan).

We then attended an evening session on Residence Life at Willamette, where Resident Assistants were on stage to answer any questions parents or students might have about living on campus. Willamette does not have any campus-wide policy with respect to "quiet hours", instead imposing 24-hour "courtesy hours", relying upon the discretion and judgment of the students to respect their peers, but also allowing individual dorms (and residences) to dictate specific rules if individual discretion and judgment do not match residents' expectations of courtesy. Other topics that were emphasized were the importance of locking doors, windows and bikes (the exclusive use of U-shaped Kryptonite locks was encouraged both in this session and the earlier session on Campus Life).

We spent the night at the Grand Hotel in downtown Salem - whose #1 rating on TripAdvisor is well-deserved - and enjoyed such a restful sleep that we missed the early morning sessions on the second day. However, we did attend the Opening Convocation at 10:30, with a keynote by Jonah Lehrer. That was such an inspiring experience in and of itself, I'm going to split that off into a separate blog post [update: I've posted my notes on Jonah Lehrer's Metacognitive Guide to College]. For this post, I'll simply note that I was also inspired by Dean Marlene Moore's opening remarks during the convocation, in which she invoked a metaphor of "curriculum as conversation", encouraged both curiosity and confusion (the latter being one of the best routes to eventual clarity), and emphasized the importance of the journey (the college experience) over the destination (the degree).

I'll finish this post by observing the synchronicity of Meg having bought Lehrer's most recent book, How We Decide, in June, before the convocation speaker was announced, and so the selection of Jonah Lehrer as the convocation speaker just adds more corroboration (for me) that Willamette was, indeed, the right decision.

Items on display at a garage sale provide myriad conversation contexts for buyers and sellers alike. Amy and I host or participate in a garage sale (or a tag sale as they're known back east) every few years, but it wasn't until this past weekend that I was struck by the way these events - and the stuff being bought and sold at them - offer rich opportunities for telling and hearing the stories of our lives.

Among the stories we heard from buyers who stopped by our garage sale were

a Russian woman who searches garage sales for winter coats she sends back to family and friends back home (she bought an old coat of Amy's)

a recently retired man who seeks out toys and games to entertain the children of his ungrateful children (i.e., his grandchildren) when they come visit

a nanny who visits garage sales with the children she watches in order to have some contact with adults (Amy gave the kids who accompanied her a few stuffed animals)

an Apache man who had made a pact with his now deceased mother not to attend her funeral so that her image - and spirit - would always be alive with her son (I'm not sure if he bought anything)

But the garage sale didn't just evoke stories from buyers, the sellers also had their stories to tell, e.g.,

a stuffed bear elicited a story about how it was given to our young son over 5 years ago by a paramedic during his ride in an ambulance (his parents had perceived the bear with significantly more sentimentality than he does at this point)

a lined flannel shirt I used to wear when we lived in colder climates evoked a few stories about how harsh those winters could be (and often were)

children's books prompted exchanges of stories by both sellers and buyers for whom the books had been meaningful in someone's childhood (the prospective buyers projecting an anticipated layer of meaning for their children)

And the stories were not only exchanged between buyers and sellers. I overheard several of the buyers - also known as neighbors - exchanging stories that were prompted by items on display among themselves, and as a multi-family garage sale, several of the sellers also shared stories about their own and each others' stuff: places we've lived, travels we've taken, hobbies we've engaged in ... and disengaged from.

I've been reading, thinking and writing about various manifestations of object-centered sociality for several years now. In a recent post on a thematic variation I call place-centered sociality, I highlighted a distinction between two dimensions of the idea of object-centered sociality: socializing about objects - e.g., talking about places and things through which we share some kind of connection - and socializing with objects - e.g., having a deep relationship with the place or thing itself. In the context of the garage sale, I heard stories representing both forms of object-centered sociality: stories in which the object for sale provided a pretext for a story in which the object was somewhat peripheral, and others in which the object was the centerpiece of the story.

For
thousands of years, we knew exactly what markets were: conversations
between people who sought out others who shared the same interests.
Buyers had as much to say as sellers. They spoke directly to each other
without the filter of media, the artifice of positioning statements,
the arrogance of advertising, or the shading of public relations.

These
were the kinds of conversations people have been having since they
started to talk. Social. Based on intersecting interests. Open to many
resolutions. Essentially unpredictable. Spoken from the center of the
self. "Markets were conversations" doesn’t mean "markets were noisy."
It means markets were places where people met to see and talk about
each other’s work.

The Cluetrain authors focus more on marketing - and its transformation via the empowerment of previously passive recipients of broadcast messages - than markets, per se, although they do talk about eBay.com as an example of a "virtual flea market". I've had very limited experience with eBay, but my impression is that most socializing there is more about the transactions rather than the stories surrounding the objects being bought and sold.

At several points throughout the two days, I was reminded of Dan McAdams' insightful book, The Stories We Live By, and his thesis that it is the stories we make up about ourselves that gives our lives meaning, unity and purpose. We start composing these stories in late adolescence - certainly by the time we are signing each others' high school senior yearbooks - and continue adding to and/or revising the narrative throughout much of our lives. Different life stages tend to provoke different editorial strategies, and the various characters we include in the unfolding story personify our basic human needs for power and love, and the things we buy and sell constitute props in the story. McAdams notes that "the good life story is one of the most important gifts we can ever offer each other" ... and these gifts were being exchanged freely by all parties throughout the garage sale. I was tempted to title this post "The Stories We Sell By" or "Sales-Centered Sociality" ... but focusing on stuff seemed more appropriate.

I imagine that this partly due to a priming effect: I recently listened to a KUOW Speakers Forum presentation by Annie Leonard, author of The Story of Stuff - a critique of our materials economy - and I think she would approve of garage sales ... aside from the fact that garages house cars which promote driving which contributes to suburban sprawl and other modern practices that degrade the natural environment. On the plus side, garage sales reduce the extraction, production, distribution, consumption and disposal inherent in our acquisition of new stuff by enabling new people to reuse old stuff, overcoming perceived obsolescence by transferring old stuff to new people at a different stage of life for whom the stuff will be perceived as fresh and useful. But I think the main contribution is that the stories and conversations that arise around the the reselling of old stuff are much more likely to contribute to our happiness than the kinds of social benefits that typically surround transactions involving new stuff.

[In checking the The Story of Stuff blog just now, I see that Saturday, May 15, was Give Your Stuff Away Day. As I alluded to above, Amy ended up giving several items away during the two-day sale, and we will be giving the rest of the stuff away.]

We feel very fortunate to have been in the excellent care of Dr. Lonergan and Dr. Hunter and the staffs at the Cascade Cancer Center and the Evergreen Radiation Oncology group, who have provided exemplary personal and professional service throughout this period. We highly recommend them as treatment providers, and I hope they won't take this personally, but I hope that we never see them again for any professional reasons.

This is the 19th - and, I hope, final - post I've written about her / our experience with the anal cancer diagnosis, treatment and recovery. I've been surprised at how much attention these posts, as well as my posts on my own experience with platelet rich plasma (PRP) elbow treatment, have received. In addition to the relatively high volume of blog comments and page views these posts receive (compared with other posts), I would estimate 90% of blog-related email I receive is based on these two categories. It sometimes seems that the more open, vulnerable and personal I am in my posts - about my experience, or in the case of Amy's cancer, the experience of a loved one - the deeper they resonate with others. However, I suspect a more significant factor is the large proportion of Internet users - 80% of online American adults (in 2006) - who search for health information online.

On a more vulnerable note, I'm chagrined to read my last post in this thread, on the 3-year anniversary, where I acknowledged my awareness and appreciation deficit with respect to her health ... a deficit that has not improved much in the past two years. I also expressed an "intention to celebrate milestones to greater effect (and affect[ion])" ... and yet when she came home last night, we had to turn our attention to preparing for a garage sale we're having today and tomorrow, getting our son to a lacrosse game and other activities of daily living. We will do something special to celebrate this milestone soon ... beyond my writing this short blog post ... which I suppose, for now, represents yet another instance of preaching what I want to practice.

I do want to end on a high note, though, as Amy's cancer was in many ways the most significant challenge we have faced together. We certainly have some challenges now, and I'm sure we'll encounter many more further down the road, but for this moment, I want to simply celebrate her success in rising to meet - and overcome - this challenge.

I am grateful for all of my circles of family and friends, offline and online, but on this day of Thanksgiving, I want to express my special appreciation for a small subset that I often call my speed dial friends: the set of my closest friends whose phone numbers I have programmed into the single-digit speed dial keys of my mobile phone (though now, with my iPhone, they are listed on the "Favorites" menu). These are the friends who I can - and do - regularly reach out to during my highest and lowest moments, who reliably help me regain a more balanced or centered perspective. They are friends who are there for me when all I need is a witness - someone will listen with empathy, and withhold judgment - or when I need an active adviser - someone who will share his or her insights, experience, strength and hope.

In some speed dial friend phone calls, I am able to discover solutions myself, simply through the act of articulating the challenge(s) I am facing, an adult version of a parent's exhortation to a toddler who is acting out to "use your words", or an oral version of the therapeutic value of writing about emotional experiences. Other times I need more active facilitation, and these friends are able to skillfully and compassionately help me elicit the hidden fears and needs that lie beneath the surface problem(s), and to separate out the data, judgments, feelings and wants. Many times, the revelation of the underlying causes of my pain shines a light on a clear path to move forward, but at other times, when the true way remains wholly lost, they are able to offer additional guidance toward the right path, or at least a path with heart.

My speed dial friends are diverse in some ways - the set includes both men and women, whose work spans different professions, and who live in different places - but most are close to my own age and socio-economic class. Many of my speed dial friends have gone through various forms of spiritual training, and all have experienced significant physical, emotional and/or spiritual crises. I suppose many people my age have experienced significant life challenges; what separates my speed dial friends may be the way they have worked through these challenges, and the wisdom they have gained through the process.

In fact, one of the common characteristics of all my speed dial friends is that they are uncommonly wise. Having recently revisited and reviewed some material on Maslow's hierarchy of needs (for my last post about Starbucks and community), I believe each of them is self-transcendent, e.g., they each "perceive unitively or sacrally" and are "much more consciously and deliberately metamotivated" and "more holistic about the world" than most of the people I encounter. I hope some of their wisdom is transmitted to me through each of our interactions.

I like to think of myself as being authentic, open and vulnerable in my face-to-face interactions as well as my online interactions with many people. I have worked out many issues simply through blogging about them, often aided by comments posted by others, and I sometimes find myself unexpectedly working out my issues while posting comments on others' blogs - a theme I blogged about in a post inspired by Don Miguel Ruiz's second agreement, don't take anything personally: commenting on commenting. I can't say, however, that I've worked out any significant issues via Twitter ... the 140-character limitation doesn't seem to allow for sufficient depth.

Speaking of depth, I feel like I've been going off the deep end on several of my recent posts, so I'm going to end this one here ... which may be a relief, and perhaps even a cause for giving thanks, for anyone who takes the time to read my blog posts. I'll note, with some sense of irony, that as far as I know, while all of my speed dial friends have mobile phones - in fact, I think nearly all of them now have iPhones - and computers, most of them don't read my blog with much regularity. So, on this day of Thanksgiving, I also want to extend my thanks to anyone who does take the time to read my posts, with special thanks to those who take the additional time to share their wisdom, insights, experience, strength and/or hope in comments on - or tweets about - the posts.

Continuing with the themes of poetry, inspiration and great friends, another great friend, Dan Oestreich, bought me a book of William Stafford's poetry, "The Way It Is", a few years ago - one of many ways he helped me navigate a dark time filled with shadows.The other night, I picked up the book - which is always at my bedside table - and randomly selected a page, which had exactly the right poem I needed at that moment, "Representing Far Places":

Representing Far Placesby William Stafford

In the canoe wilderness branches wait for winter;every leaf concentrates; a drop from the paddle falls.Up through water at the dip of a falling leafto the sky's drop of light or the smell of another starfish in the lake leap arcs of realization,hard fins prying out from the dark below.

Often in society when the talk turns wittyyou think of that place, and can't polarize at all:it would be a kind of treason. The land fans in your headcanyon by canyon; steep roads diverge.Representing far places you stand in the room,all that you know merely a weight in the weather.

It is all right to be simply the way you have to be,among contradictory ridges in some crescendo of knowing.

I re-read the last verse several dozen times that night, as I was struggling with a decision in which my thoughts were leading me along one contradictory ridge, and my feelings were leading me along another. As luck - or synchronicity - would have it, the previous day, I'd shared an insight with someone I'd just met about how, as I grow older, I trust my heart more than my head when it comes to decisions of great import ... and, as I grow older, I increasingly recognize that any insights or experiences I share with others - with the initial intention that they may be of benefit to them - are always things that I really need to read / hear again myself.

Anyhow, I sent Dan a quick note thanking him for the gift that keeps on giving, and he magnified the gift by turning it into a motivational poster entitled "Among Contradictory Ridges", accompanied by one of his fabulous photos:

In addition to being a great friend, Dan is also a great leadership coach (and a great photographer), and he followed up his "Among Contradictory Ridges" motivational poster with another one reflecting one of the central themes in his work (with his self, other selves and Self) - an Unfolding Leadership Poster - in which he observes "The problem is self. The answer is Self":

Quickly think of five common traits of high-impact leaders… good
time management, assertiveness, drive, energy, charisma, etc. Humility
rarely lands in the list when it comes to our modern, top-down
management systems. But Jesus (the greatest leader ever) and Moses
(perhaps the second) had this one thought in mind – great leaders don’t
have power over people, but power under people by way of humility.

Humility may be a forgotten virtue in conversations about leadership today, but
I believe it’s absolutely essential to having long-term, broad-range
impact. Here are some reasons why…

Until you can be managed well, you can’t manage well, and being managed definitely requires humility.

You’re not leading well until you put the needs of others before your own, which requires humility.

You won’t invest time into others until you realize you’re not the center of the universe.

You won’t be a learner without humility, so you’ll stagnate and die on the vine.

You can’t be a listener without humility, and when you don’t listen, you’ll miss some vitally important feedback.

Receiving and making the most of constructive criticism definitely demands humility.

Being concerned about the personal welfare of others requires humility.

You won’t improve unless you realize your need for it, which requires humility.

You can’t be sensitive to what’s going on the behind the words of
others unless you’re paying attention, which requires humility.

The respect you think others have for you will merely be an
illusion unless you’re humble enough to see the reality of your own
weaknesses.

Humility isn’t feeling bad, down, or low about yourself. Rather,
humility is having a realistic picture of who you are and becoming
oblivious to self. This self-oblivion characterizes the greatest
leaders of all time, and if you want to rise to greatness, you need to
stoop.

Thinking about self-oblivion as a feature, rather than a bug, is a provocative new dimension to consider as I travel among contradictory ridges in some crescendo of knowing.

The following poem was composed by my great friend, Len Silverston, a spiritual teacher and database guru. I am posting it here with his kind permission ... and can't help thinking "When the reader is ready, the poet appears".

Direction(Where I go, matters less than where I come from)by Kensho Len Silverston

It matters less which direction I head,Or even where I start,What matters more is that the path I choose,I follow with all my heart.

It matters less what direction I journey,If it’s north, south, east or west,What matters more is that I walk strong and tall,And do my absolute best.

It matters less which site I pick,And whether it suits my so-called “needs”,What matters more is that I fully appreciate,All of its qualities.

It matters less if it rains or shines,Or if it’s overcast,What matters more is that I be with what is,Cause whatever it is won’t last.

It matters less in relationships,If I confront or just let go,What matters more is that I come from who I truly am,And let my love and authenticity show.

It matters less to prove anything to anyone,Or whether I accomplish or succeed,What matters more is that I love myself,Enjoy, and serve those that are in need.

It matters less to try to change,Anything outside of me,What matters is to really be the change,That I truly want to see.

It matters less in my vocation,If I’m a Zen priest or a database guru,What matters more is that I follow spirit,In whatever I choose to do.

It matters less that I have a precise direction,Or know exactly where to go,What matters more is that I’m perfectly fine,Even if I just don’t know.

We saw Jackson Browne in concert at Chateau Ste. Michelle last night. The Rock and Roll Hall of Famer and his fellow musicians gave a crisp, clean performance of many familiar songs on an unseasonably cool evening at the winery. Of all the concerts I've seen at the winery - nearly all of which are by musicians who first gained fame in the 60s and 70s - Jackson Browne, now 60, looked and sounded the strongest. The band played and sang well together, the sound was perfectly mixed (nothing was too loud or too soft), and - unlike the recent Dave Mason concert at CSM - there was plenty of banter with the audience.

The aspect that most stood out for Amy and me - and other friends who were with us - was the outstanding vocals provided by Chavonne Morris and Alethea Mills. They were seated on stools in the background throughout most of the first set, mostly providing background vocals for the songs; at one point, Amy - always attuned to vocals and vocalists - turned to me and asked "when is he going to let them cut loose?" Well, we didn't have to wait long. In the second set, they were on their feet, and their solos during the third song, "About my imagination", really opened things up. Their solos in the next song, "Lives in the Balance", kept the momentum building throughout the set.

While the women, who joined the group fairly recently, were the standouts, the rest of the band, who have been playing with Browne since 1993 - Kevin McCormick (bass), Mark Goldenberg (guitars), Mauricio Lewak (drums) and Jeff Young (keyboards, backing vocals) - were all [also] outstanding. The bass player is also the producer, and I wondered how much his involvement on stage influenced the incredibly balanced sound mix we were treated to during the show. Another highlight was the guitarist's use of what my friend Bruce said was a 11-string fretless guitar that provided an eastern sound during "Lives in the Balance" (by the time the binoculars got back down to me, the song had ended).

Other highlights included the last song of the first set, a rocking rendition of the classic song, "Take it Easy", which [I didn't previously know] Jackson Browne co-wrote with Glenn Frey of the Eagles, the band that popularized the song, making it one of The Rock and Roll Hall of Fame's 500 Songs that Shaped Rock and Roll (Browne's own performance of another song, Late for the Sky, is also on that list). And, of course, the most classic encore song of all time, Stay, was great to see live as the second and final encore.

We are very fortunate to have good friends - Bruce, Jay and others (pictured on the right) - who were willing to go to the winery early and reserve a spot in line. I've been asked not to reveal how early they got there, but it was sufficiently early that we were the first in line - at the main gate - to vie for the lawn seats. Unfortunately, they opened up the south gate a minute or so before the main gate, and so we didn't get the front "row" on the lawn, but we were right in the center in the second and third rows, which gave us a fabulous vantage point from which to watch the concert.

I've always enjoyed Jackson Browne's music, but have never owned any of his albums, and so while I recognized most of his songs, I had to use my iPhone browser to look up the names of songs based on some of the key lyrics. I also used the iPhone Notes application to keep track of the songs, which worked better than the small pad and pen I used at the Dave Mason concert (where darkness and rain compromised the legibility of my notes). The following is, I believe, a fairly accurate representation of the set lists played at the concert:

My wife, 17-year-old daughter and I toured four colleges in Oregon during her mid-winter break: Reed College, Lewis & Clark College, Linfield College and Willamette University. I wanted to record a few impressions of the different places while the experience is relatively fresh, and decided to post them here, in case they are of use to others ... or in case others might have relevant insights and experiences to share via comments.

In my recent post about positivity, praise, practice and perseverance, I wrote about some of my struggles with respect to projecting my self - and my past - onto my 13-year-old son - and his future. During our college tours, my wife and I - who first met while we were students at Ripon College, a small midwestern liberal arts college - both encountered variations on this struggle with respect to our daughter during our initial college tour with her. Although she has far greater motivation, discipline and achievements in her academic pursuits than either of us had at this age, we both have to remind ourselves - or, more commonly, each other - that we want our daughter to choose the school that she believes is best for her, not the one that we believe is best for her ... or, the one that we might like to believe we would have liked to attend ourselves.

Before sharing some observations about the colleges we visited, I want to provide a little more context. Our daughter is primarily interested in a small liberal arts college within reasonable driving distance - or a short flight - of our home in the Seattle area. As a junior in high school, she does not yet know which subject(s) she wants to major in yet, but is generally interested in Biology, Spanish, International Studies - or, at least, studying abroad - and Psychology. She wants a challenging and supportive learning environment in which she can explore these - and other - interests, and where she can interact with other students who are highly motivated and disciplined in their academic pursuits. Debbie Cossey, of Rainier College Counseling, has been very helpful in helping our daughter (and her parents) identify the most important criteria in her consideration of colleges, as well as proposing a specific list of colleges that best meet those criteria, including the four colleges on this tour.

Finally, I want to note that although we have some money set aside to support education, financial aid provided by institutions will be an important factor in our deliberations, especially given the high costs of many of the schools we're considering, and growing economic uncertainties. It is challenging to figure out how much financial aid would be available to any given student at any given institution; definite calculations of costs will have to wait until applications are made by prospective students, and admission decisions are made by the institutions. One institution on our list of candidates, Pacific Lutheran University - which we did not visit on this tour - doesn't even provide tuition information on it's web site, only noting that "On average, when scholarships, grants and other assistance are factored in, the average PLU student’s yearly total is closer to $11,000". I frankly don't know whether we'd be able to afford any of the colleges on this tour, but we thought it would be good to aim high, at least at the outset. There are several places that we're planning to visit in the future ... some of which are considerably less expensive than the ones we've started out with.

Our first stop was Reed College, in the southeast part of Portland, which has an enrollment of 1,464 students. Of the four schools, Reed appears to be the most selective and academically rigorous ... and the most expensive; it also had what I found to be the most inspiring motto: "Inquire within". Reed accepted 34% of applicants to the class of 2012; among those who entered the class of 2012, average high school GPA was 3.9, SAT scores for critical reading and mathematics among the middle 50% of incoming students ranged from 1290-1470 (or 1940-2210, with writing scores included) and 65% of students were ranked in the top 10% of their high school class. Students must complete a senior thesis in order to graduate, which I would expect is helpful preparing the large proportion of students - the third highest of any college in the U.S. - who continue on to graduate study. All of this comes at a price, of course: $39,120 in tuition and fees, $9,920 for room and board, for an annual estimated cost of $49,040.

What impressed me the most during our tour of Reed was the student:faculty relationships. The student:faculty ratio was relatively low (10:1) - as was the average class size (15) - and the quality of relationships seemed relatively high. During our visit to the library, we went to the room where all the senior theses are stored. I picked out a few random volumes, and was struck immediately by the Acknowledgments sections in each one, where people who I inferred were professors were being referenced by their first names. I asked our tour guide about this, and she confirmed that was very much the norm at Reed, and went on to say that professors typically invite their students to dinner each semester, and regularly meet with them for lunch or coffee. There was only one department at Ripon where we commonly addressed professors by their first names (Marty, Seth and Steve in Politics & Government), and I only saw the inside of two of my professors' houses during my four years there ... and never shared a meal or coffee with any of them. The relatively low power distance index may help explain why students seem to be highly empowered and relatively autonomous at Reed. As one example of this, they not only have theme dorms, but the themes are proposed and voted on by the students. The relatively wide variation in styles of dress may be another indicator of high autonomy and independence. I also noticed a surprisingly large number of cigarette smokers on campus.

We stayed overnight at Hotel Lucia in Portland, which has a great location (just south of the Pearl District), very comfortable beds (though they were only double beds), and an intriguing collection of photographs (by David Hume Kennerly), but a rather small bathroom (especially for use by three people). Our daughter was hosted for a dinner on campus by a Reed student, while Amy and I enjoyed a fabulous - and surprisingly inexpensive - dinner at The Farm Cafe. We strolled around the Pearl District for an hour or so, before turning in for the night.

The following morning, we visited Lewis & Clark College, in the southwest corner of Portland. Compared with Reed, Lewis & Clark has a larger undergraduate population (1,999), is less selective in its admissions (56% acceptance rate, with an average GPA of 3.69 and middle 50% SAT score ranging from 1200-1380), has a higher student:faculty ratio (13:1) and higher average class size (19), and is less expensive ($33,726 tuition and fees, plus $8,820 room and board, for an estimated annual cost of $42,546). One of the things we find especially appealing is that over 50% of students study abroad at some point in their college experience.

When we reached the campus, we were immediately struck by the grandeur and beauty of the Frank Manor House and its spectacular view out the back toward Mount Hood. Our tours at the other colleges were relatively small - one or two students and their parents, at most - whereas there was an extremely large tour group at Lewis & Clark. Even after breaking up into three subgroups, each with a separate tour guide, I'd estimate that each group had somewhere around ten students each. And I don't know if it was the size of the groups or the personality of the student body, but our group was "acknowledged" far more than anywhere else with a variety of greetings ranging from jeers of "Prospies!" (presumably short for "prospective students") to a student shouting "You should come here, you'll love it!" as he whizzed by on a bike. Other things that stood out for me, especially in comparison to Reed, include a stronger focus on fine arts - they have strong programs in Art, Music and Theater - an NCAA Division III sports program, graduate programs in Education and Counseling and Law, and a policy of not allowing freshman students to have cars (on campus) - the only school we visited that had such a restriction. Like Reed, Lewis & Clark offers theme housing. After the tour, the three subgroups reconvened in an auditorium, where the Associate Dean of Admissions was available to answer any and all questions.

After a quick lunch, we headed southwest to visit Linfield College, in McMinnville. Linfield has 1,693 undergraduates, and compared with Lewis & Clark, is less selective in its admissions (80% acceptance rate, with an average GPA of 3.56 and middle 50% SAT scores ranging from 990-1220), has a similar faculty:student ratio (13:1) and average class size (18), and is less expensive ($27,414 in tuition and fees, $7,970 in room and board, for a total cost of $35,384). Although they have no graduate program, as with Lewis & Clark, there is a strong emphasis on study abroad, with nearly 60% of students spending some portion of their college career outside of the U.S. They actually require student majoring in a foreign language to spend a full year studying in a country in which that language is spoken (requirements for a minor include a semester in a foreign country).

Several things impressed us during our tour of the campus, which in many respects seemed like a midwestern campus plunked down in the Pacific Northwest. The mostly brick buildings and the grounds were very well kept, and had a very open, expansive feel to them. Everyone we encountered was extraordinarily friendly, with many students on campus making eye contact and smiling as we passed. We saw more school sweatshirts at Linfield than all the other campuses combined, suggesting a strong school spirit (and, perhaps, a stronger emphasis on sports, though Linfield, like Lewis & Clark is NCAA Division III). During our 1:1 meeting with the Admissions Counselor, we learned about an annual scholarship fair each February, in which prospective students are invited to visit campus to compete for departmental scholarships.

We had an early dinner at McMenamins Pub at Hotel Oregon, where we had great salads, but so-so entrees and average beer; next time we'll try the Golden Valley Brewery & Pub. We then drove down to Salem, where we stayed at the Phoenix Grand Hotel, which offered a more spacious double queen suite than we had the previous night. Everyone was tired, so we didn't take advantage of the hotel location to explore downtown Salem that night.

The next day, I left early for a business meeting in Corvallis while the women explored a bit of Salem on their walk over to the Willamette University campus. Willamette seems to represent a sort of middle ground among the institutions we visited, with 1,780 undergraduates, a median GPA of 3.74 among the entering class of 2012 (not sure what the mean is) and a median SAT score of 1850 (reading + mathematics + writing). The faculty:student ratio is 10:1, with an average class size of 14, and 57% of students earn credit for study abroad. The university includes graduate programs in Law, Business and Education. Some of the statistics Willamette provides are slightly different in nature than those provided by other institutions (e.g., medians vs. means), so direct comparisons are difficult.

Unfortunately, by the time I returned to Salem, the official tour was over, but I heard that the tour and tour guide were both great. Amy gave me a quick mini-tour, pointing out three highlights of the campus: the open areas within the Olin Science Center in the middle of classrooms, labs and faculty offices where students and faculty can hang out; the student-run on-campus coffeeshop, The Bistro, which seemed to have more energy and activity than coffeeshops we saw on other campuses; and the grove of five giant Sequoias - the "star trees" - in front of Waller Hall, the main administrative building. She also mentioned that there is an Amtrak train station - with service to Seattle - right across the street from the campus.

Seeing the campuses first-hand helped highlight some differences that we hope will ultimately help in selecting the best college, i.e., the institution that provides the best environment to both challenge and support our daughter in her academic pursuits and personal growth, balanced against the cost of attending the institution. The costs of attending the institutions we've visited thus far are pretty high, and we'll be visiting other candidates that are considerably less expensive. Quality:price ratios are much harder to calculate than student:faculty ratios, given the complex array of factors that influence both the benefits and costs of college for any given individual (and family). Our first round of campus visits was helpful in assessing some of the benefits, but ascertaining the actual costs may well have to wait until applications are sent, admission decisions are made, and financial aid packages are offered.

A recent New York Times article on "Colleges fretting over admissions" notes that colleges and universities are also facing challenges in their calculations - who to admit, how many to admit, how much aid to offer, how to increase the probability that admitted students will commit to attending - due to the growing economic uncertainties. These uncertainties may ultimately work in students' (and parents') favor:

For students, the uncertainty could be good news: Colleges will admit more students, offer more generous financial aid and, in some cases, send acceptance letters a few weeks earlier. Then again, it could prolong the agony: some institutions say they will rely more on their waiting lists.

But there is no question, admissions officers say, that this year is more of a students' market.

It's still early in the process for us - early applications aren't due until November, and regular applications aren't due until next February - but I think that visiting the campuses helped make the prospect of college more real for our prospective student. Amy and I were both significantly influenced by our visits to Ripon College (as prospective students), and our visits to these four helped us formulate some relative rankings, and to be better prepared for what to look for - online and offline - during our exploration of other candidate colleges in the future.

[Update, 2010-08-29]

Charley's comment prompts me to post a few notes about subsequent visits and other developments in our exploration of educational institutions in the Pacific Northwest (and California).

After our initial tour of the four colleges listed above, Meg visited the following other colleges and universities:

I only accompanied her on the visit to the University of Puget Sound, and my notes are rather sketchy from that trip. The thing that most stood out - for me - was the emphasis on writing at the school: this was mentioned by our tour guide as well as in other interactions with administrators during our visit. I have always believed that writing is one of the best ways to figure out what and how I really think about something (which is why I blog semi-regularly), and so I saw this as a positive feature. Meg is a very good writer, but I don't believe her enthusiasm for this channel of expression is quite as high as mine.

She eventually applied to and was offered admission to Lewis & Clark College, Willamette University, Linfield College, University of Puget Sound, Western Washington University, Chapman University and Santa Clara University (which she did not visit). Many of the offers included some level of scholarship. We visited Willamette and Linfield again this past February, during her mid-winter break: she stayed overnight at Willamette with a student host at the Kaneko dormitory, and attended two classes the next day; at Linfield, we met with a freshman woman (and her father) who had graduated from Meg's high school the preceding year, and was very positive about her experience at the college thus far.

Another resource that influenced our decision was some information I found (and wrote more extensively about on my Posterous milliblog) about Pacific Northwest College Professors of the Year awards. While I recognize that all awards or rating schemes have implicit and explicit biases, and would not recommend using such awards as the primary criteria for selecting a school, I do believe they represent a dimension worth considering, Among the schools we considered, here is the breakdown of professors who have won the U.S. Professor of the Year Award:

Deciding among these schools was challenging, and I think the second trip to Willamette, in particular, was very helpful. Our daughter ultimately decided that Willamette offered the best overall fit for her goals with respect to educational quality, campus life and scholarship. I suspect distance from home was also a factor: far enough away that her parents won't be dropping in unexpectedly, but close enough that she can drive or take the train home for a long weekend if / when she is so inclined. And as might be inferred from my recent posts on a warm welcome at Willamette University Opening Days and the Willamette convocation keynote, Jonah Lehrer's Metacognitive Guide to College, we are all confident that this was a good decision.